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HomeMy WebLinkAboutBLD2002-00034 Wellhouse and Pump - BLD Permit / Conditions - 1/22/2002 a MECHANICAL MOBILE HOME Fo. "Setback / date by Ribbons da"s 6 �Z by Gas Piping date by Foundation Walls date by Set Up date by INSULATION date by BG/SLAB Insulation Floors Final date by date by date by FRAMING Walls FIRE DEPT. date 3 by T��. date by date by PLUMBING Attic OTHER Groundwork date by T�� date by WALLBOARD NAILING D.W.V. date by date water Line FINAL INSPECTION date by date by date by 7""z2 43.e 7 G �- Building Permit # Z -c� 7�'� MASON COUNTY BUILDING 111 426 W. CEDAR SHELTON, WASHINGTON 98584 (360) 427-9670 CORRECTION NOTICE Job Location 24-Z-/ V/)� pis This structure has been inspected by Mason County Building Department and the following VIOLATION of County Laws and Ordinances has been found: Items Listed below must be corrected to gain code compliance t> �v ►y i 2- You are hereby notified that the above corrections shall be made BEFORE PROCEEDING WITH ANY FURTHER WORK ❑ Call for re-inspection when corrections are made before continuing ❑ Make corrections, items will be checked on next inspection ,OK to I vsvL /, /❑ This is not a complete inspection Department 1-3 Date Z 7 ©2. Inspector DO NOT REMOVE THIS TAG o ni m 6 K < rm- O O '0 m y � � r � m o a v o m 0 n G7 O c o c -i D c�i C) cn 0 r 0 c ,oc4! 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N 'il c N v mD 7 C Q A 0 a O O A � � 3 m C - sa O. d c (D 0_ 3 PERMIT NO.: BLD MASON'COUNTY BUILDING PERMIT APPLICATION 426 W.CedatlP.O.Box`181,Shelton,WA 98584 Shelton 360 27-9670 Belfair 360 275-4467 EIma 369 -b26s Seattle-(206146449618 APPLICANT JNFORMATIPN CONTRACTOR INFORMATION Owner "" R g 1W Contractor Name "` Mailing Ad ress Mai�Iiing;�Ad�dress p �# w City ,j� Sta-te'J&A Ziip ode 41,55 2,6 City v. State Zip Code Phone( SW '2:Z4. Other Ph.( ) Ph.(J#*O ) 10'7+-Zloo Other Ph.( Lien/Title Holder Contractor Contractor Reg. # Address C Expiration / f�_i 0 ' 'SEPTICIWATEK SYSTEM INFORMATION-Connect'to w Septic Existing Septic Connect to Sewer System Name of Sewer System Well Well Water System Name of Wafer System. E -.7# PARCEL INFORMATION-12 digit Tax Parcel No. Fire District Legal Description SiteAddress(Please include street name, street number and cit ) IDireditionsto site WO-0- 0AJ Rt­g X to, t o . 4 Lo,art, a t. Will imbe.r be cut and sold in parcel preparation? (Yes/No) Lp y,'Qr LRt=T your property within 200' of the following: Body of Water(Name) Saltwater I ke River/Creek Pond Wetland Seasonal Runoff Stream Slopes or uffs RESIDENCE❑ SEASONAL RESIDENCE TYPE OF JOB New Add Alt Repair Ot erTUse of Suildin Describe Work JS# C. / No. of Bedrooms No. of Bathrooms ;'r�`$OUAR OTA E-1st Floor__310 2nd Floor 4.f,4 3rd FloorL; oft Az Basement_ Deck r.� Other A sq. ft. Garage Attached Detached Carport Attached Detached 1MOBILE HOME INFORMATION-Make Model Model Year. Length Width Serial No. If 7�C No. of Bedrooms' No. of Bathrooms Type of Heat Purchase Pn'cn f Replacement Unit?(Yes/No) 1nstaller Name Certification No. NOTICE : THIS PE{tMIT BECOMES NULL&VOID IF 1NORiE STRUCTION At IS COMMENCED WI'iHIN 180 DAYS OR IF CONSTRUCTION ORK IS SUSPENDED OR ABANDQNED FOR A P IOD OF 180 DAYS AT ANY AFTER THE WORK IS t;OMMENCED. PROOF OF CON ATK)N f3F � NS:OF A PROGRES; INSPECTION. The owner or agent on owner's behalf,-represents that the information provided is accurate a`n'd'g fees of Mason;;County access to the above described property and structures for review and inspection of .this project Acknowledgment of swch it-by stgneture below: .y OWNER AFFIDAVIT4 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-1 c*tify that I am currentl" registered as a-' Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and thVam aw'> .the L ,*ce requirements for which this permit is issued and that all work will be done in requirements regulating the work f®r which this pertifid id is u&and*Pwork conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining a pr I: X Date "tl pate ) FOR OFFICIAL USE BEYOND T rVD POINT Accepted by Date Submittal Amount Due Receipt-No. >: :. .. Building Department Occ Group Type Constr. Planning.Department c* Environmental Health Department Public Works Department Fire Marshal' Valuation$ Building Permit Fee Site Inspection Plan Review Fee EH Review Fee Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other 'ood/Gas/Pellet Stove Fee State Fee 77 Violation Fee Pre-Paid at Submittal (. ) TOTAL FEES PERMIT NO.. BLD ' MASON COUNTY BU1LD1[ fG PERMIT APPLICATION h , 426 W.Cedtirr.P.O.Box 186,Shelton,WA 98584 f Shelton 360 427-9670 Belfair 360 2754467 Elma 360 2-5269.Seattle 206 464.6968 APPLICANT JNFORMATIPN,, CONTRACTOR INFORMATION Owner contractor Name 5�A w i7A IM @ Co�s a►c�lorl l Mailing Ad ress Mailing Address ic IF S+. H&4.pq % w City Z!le StateWA Zip ode 61,551.4 City ;b*+ QvchA4 State Zip Code 9S13Ve Phone( Sk0) 2_7!5_' Other Ph.( ) Ph.(Neo &I-I-216D Other Ph. Lien/Title Holder A�!1A Contractor Reg.# 57• hN - pL ZOZ W I= Address I Expiration l ( 1 ,. Z 'SEPTIC/WATER SYSTEM INFORMATION-Connect to %w Septic Existing Septic Connect to Sewer System Name of Sewer System � Well Water System Name of 1 Water System PARCEL INFORMATION-12 digit Tax Parcel No. Fire District Leg IDescription t41 • 3 Site�Address(Piease include street name, street number,and cit ) Direbl ons tq site QAJ 14A.- e h v� 1"y a,7 4 40 we- a t I V , Will imber be Cut and sold in parcel preparation? (Yes/No) u d "Gr s your property within 200' of the following::Body of Water(Name) Saltwater ke _ River/Creek Pond Wetland Seasonal Rurioff Stream Slopes or luffs I R NT.RESIDENCE LI, SEASONAL RESIDENCE❑ TYPE OF NOB New Add Alt Repair. Ot er Use of uildin w Describe Work Alnek lap � � No: of Bedrooms ' No.'of Bathrooms `S'OUARE OTA E-1st Floor 3Z0 2nd Floor •4 3rd Floor. Loft L Basemen Deck y.4_Other w,r4 sq. ft. Garage ,, Attached Detached Carport Attached Qetached MOBILE HOME INFORMATION=bake Model Model Year Length Widt Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Pric . - ;, Replacement UnitI(YesHVd), Installer Name Certification No. 'NOTICE: THIS PERMIT BECOMES NULL&VPJD•IF INOR STRUCTf IN AUT►4ORIZED IS OMMENCE�2• 780.�IAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR A6ANDONED FORA P IOD OF 180.DAYS AT ANY IWAFTER THE WORK IS COMMENCED. PROOF IJF CONlIATtON G1F NS OF A PROGRES INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accuratee an tees of Maso_nC unty access to the above described property and structures for review and inspection of this project. Acknowledgment of-suchis-by-stgiiature below: OWNER AFFIDAVIT4 certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I c46y that I am cujwar',, `en1:0'r tered as a- Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and thaNlapi the& ce requirements for which this permit is issued and that all work will be done in requirements regulating the"work fqr which this p is ed an a k conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining a r al. X Date X L f" Date o t 01.. FOR OFFICIAL USE BEYOND TH POINT , Accepted by Date Submittal Amount Due Recei Building.Depa . nt a�i;l►.�,, `* -• Occ'Grou � Type Cons . 0,2.. Planning Department77,0 go e, SoLvieke- Environmental Health Department Public Works Department Fire Marshal j Valuation $ . Building Permit Fee Site Inspection Plan Review Fee EH Review Fee { Plumbing&Base Fee Planning Review Fee' Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee violation Fee Pre-Paid at Submittal J ( ) TOTAL FEES 4 FAX �R STAN PALMER CONSTRUCTION,INC. 5107 STATE HWY 3 SW PORT ORCHARD,WA 98367 PHONE:(360)674-2100 CONSTRUCTION FAX: (360)674-7190 sT AN-PC-*202NF To: Mp5ale., 'r, &NO 'i�)e P4 Phone: Fax: B ulo-- k—?7q b Pages: Atha: r kq t lVs Date: Z_c(_ p Z Re: hNo'y) CC: []'Urgent ❑For Review F]Please Comment Please Reply ❑ Comments: VC! v -T-in1 It 0 st°e ATTV�cweto !'11� A-.o bo«� _v vDw-tr p sr. �u w.,a houses etrur.-c-r No , 2-o3z-6e%0344 . r enOlC �C Lr tc�a,nesi�eP2 �3Cao� 310— C*2 7 �fc� — 1z�too) 24 a O W\A z-mf d 4-trO Se�ader• Original: Mailed Not Mailed �/ 1 ail tom F�-qe� 25000 9.tL7 \ �TµwY3 Ow c 6,D-b i tl 9� S i ti 9 ' To6 s r'1 3 L Fppr vz- FORM MUST BE COMPLETED IN INK PERMIT NO.: BLD PLEASE PRESS HARD MASON COUNTY BUILDING PERMIT APPLICATION 426 W.Cedar/P.O.Box 186,Shelton,WA 98684 Shelton 360 427-9670 Belfair 360 275.4467 Elma 360 482.6268 Seattle 06 64.6968 APPLICANT FORMATI N CONTRACTOR INFORMATION Owner, tC \A1n tv I�►�,�-v c NQ • Contractor Name �,►vc to Mailing Address w Mailing Ad ress Io City State Zip ode q S5 Zlb City +� r State Zip Cade 9Y i�Z 4� Phone( Sbo 275-11Other Ph.( ) Ph.(i ) 1,7-/-2AOD Other Ph.(,�) Lien/Title Holder Aiiii Contractor Reg. # S'T-kIy PL ' 2-0214 I= Address I MA Expiration / /L /_0� r EPTIC/WATER SYSTEM INFORMATION-Connect to SepticExisting SepticConnect to Sewer ystemName of Sewer System WellWater System Name of ater System I Z- t ^� PARCEL INFORMATION-12 digit Tax Parcel No. Fire District Legal Description 'Sirr AWj3CAgD L Ag 67 1 327271 Site Address(Please incluu,de street name, street number and cit i Directions to site 41;T a" +�-- t• ' L'` ' is fA r Y1,V Will imbe.r be cut and sold in parcel preparation? (Yes/No) IJ 0 5t ' Is your property within 200' of the following: Body of Water(Name) Saltwater Lake River/Creek Pond Wetland Seasonal Runoff Stream Slopes or ' Bluffs PERMANENT RESIDENCE❑ SEASONAL RESIDENCE 0 TYPE OF JOB New_Add Alt Repair_- Other Use o f Pudding �M /[ A a s Describe Work ra No. of Bedrooms No. of Bathrooms SQUARE OTA E-1st Floor 3ZG 2nd Floor �v ft- 3rd Flooru A- oft N& Basement Jam_Deck iy Other xi sq. ft. Garage Attached Detached Carport Attached Detached MOBILE HOME INFORMATION-Make Model Model Year Length Width Serial No. No. of Bedrooms No. of Bathrooms Type of Heat Purchase Pric $ Replacement Unit ?(Yes/No) Installer Name Certification No. NOTICE: THIS PERMIT BECOMES NULL&VOID IF WORK OR CONSTRUCTION AUTHORIZED IS NOT COMMENCED WITHIN 180 DAYS OR IF CONSTRUCTION WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 180 DAYS AT ANY TIME AFTER THE WORK IS COMMENCED. PROOF OF CONTINUATION OF WORK IS BY MEANS OF A PROGRESS INSPECTION. The owner or agent on owner's behalf,represents that the information provided is accurate and grants employees of Mason County access to the above described property and structures for review and inspection of this project. Acknowledgment of such is by signature below: OWNER AFFIDAVIT-I certify that I am exempt from the requirements of the CONTRACTOR'S AFFIDAVIT-I certify that I am currently registered as a Contractor Registration Law RCW 18.27 and am aware of the ordinance contractor in the State of Washington and that I am aware of the ordinance requirements for which this permit is issued and that all work will be done in requirements regulating the work for which this permit is issued and all work conformance therewith. No changes shall be made without first obtaining shall be done in conformance therewith. No changes shall be made without approval. first obtaining appr al. Date X Date d Z z— FOR OFFICIAL USE BEYOND TiriPOINT Accepted by Date Submittal Amount Due Receipt No. Building Department OCA . Occ Group Type Constr. Planning Department fla L Environmental Health Department Public Works Department Fire Marshal Valuation $ Building Permit Fee Site Inspection Plan Review Fee EH Review Fee 77 Plumbing&Base Fee Planning Review Fee Mechanical&Base Fee Other Wood/Gas/Pellet Stove Fee State Fee Violation Fee Pre-Paid at Submittal ( ) TOTAL FEES,